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At least 991 records · Page 55Linked to original sources
PubMed2002

Extracorporeal photochemotherapy for the treatment of graft-versus-host disease.

Photopheresis (extracorporeal photochemotherapy, ECP) is a new type of photochemotherapy used for the treatment of oncological and autoimmune diseases. Additionally, recent reports indicate that this therapy is promising in both pediatric and adult patients who develop graft versus host disease (GVHD) resistant to conventional protocols after bone marrow transplantation (BMT). In this paper, we review 31 studies where ECP was used in the treatment of acute and chronic GVHD. A total of 76 (32% female) acute GVHD patients have been considered in 11 series. Fifty-nine patients presented with skin involvement; 47 had liver involvement, and 28 had gastrointestinal manifestations. Treatment duration ranged from 1 to 24 months. A regression of skin manifestations was observed in 83% of the patients with a complete response in 67%. A complete regression of liver and gut manifestations was reported in 38% and 54% of the patients, respectively. The overall patient survival was 53%. Of the 43 patients alive, 8 developed chronic GVHD manifestations. The immunosuppressive therapy was discontinued in 28% of cases and reduced in 46%. A total of 204 (45% female) chronic GVHD patients treated with ECP 1 to 110 months from transplantation have been considered in 20 series. One hundred twenty-eight patients presented with skin involvement, 84 with liver, 31 with lung, and 59 with oral manifestations. Treatment duration ranged from 3 to 40 months. A regression of skin manifestations was observed in 76% of patients with a complete response in 38%. An improvement of liver and lung involvement was reported in 48% and 39% of the patients, respectively. Of the 59 patients with oral manifestations, an improvement was obtained in 63% of cases. The overall patient survival was 79%. ECP is a nonaggressive treatment that may benefit patients with both acute and chronic GVHD who do not respond to standard immunosuppressive therapy.

Adolescent↗
PubMed2001

Craniofacial and dental characteristics of Kabuki syndrome.

We describe oral manifestations in six patients (three females and three males aged 6 to 24 years) with Kabuki syndrome (KS), based on their physical, orthopantomographic, and cephalometric findings. All six patients had a high-arched palate, malocclusion, most commonly unilateral posterior cross-bite (5/6), severe maxillary recession and mid-facial hypoplasia. Other frequently observed oral manifestations included small dental arch and hypodontia. Three patients lacked permanent teeth, mostly the central/lateral incisors. Both tooth size (in primary and permanent teeth) and dental arch (in length and width) tended to be small. We would like to stress that oral care and management is a must for the well-being of KS patients.

Adolescent↗
PubMed1991

Periodontal disease in heterosexuals with acquired immunodeficiency syndrome.

We studied the prevalence and severity of periodontal disease among 181 heterosexual men and women with AIDS. Included were 167 (92%) intravenous drug users (IVDU) and 14 sexual partners of persons at risk for AIDS. Periodontal disease was seen in 71 of 78 (91%) women compared to 75 of 103 (73%) men. Gingivitis was the most severe form of periodontal disease in 7 (9%) women and 15 (15%) men. Increased severity of periodontal disease was seen in women as compared with men (P less than .001); among subjects with periodontitis, 48 (75%) of 64 women had moderate to advanced disease compared to 32 (53%) of 60 men. For individuals with periodontitis, the extent of involvement was associated with severity; 90% of subjects with advanced periodontitis had all 4 quadrants affected. Concurrent oral manifestations of AIDS, including candidiasis, hairy leukoplakia, ulcers and Kaposi's sarcoma were present in 167 (92%) subjects. We conclude that HIV-associated gingivitis and HIV-associated periodontitis are common in heterosexual men and women with AIDS and are often accompanied by other oral manifestations of AIDS. The reason periodontal disease is more severe in women is not known. Clinicians should be aware that these disorders occur in heterosexuals as well as in homosexual men. Further study will be necessary to delineate the pathogenesis of these disorders.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Systemic conditions, oral findings and dental management of chronic renal failure patients: general considerations and case report.

Chronic renal failure is a relatively common systemic disease. Systemic abnormalities such as anemia, platelet disorders and hypertension as well as oral manifestations including xerostomia, uremic stomatitis, periodontal disease and maxillary and mandibular radiographic alterations can be observed in individuals with chronic renal disease. In view of its frequent occurrence and the need of knowledge by dentists dealing with this condition, this paper discusses the most important issues regarding chronic renal failure, addressing its systemic and oral manifestations and the dental management of chronic renal patients. A case report is presented.

Adult↗
PubMed1989

[Stomatologic pathology in HIV infection. Preliminary data].

In order to investigate the clinical oral manifestations associated with Acquired Immunodeficiency Syndrome (AIDS) and AIDS-related conditions, 922 male subjects were studied in a closed community (inmates). 669 were drug-abusers, 24 homosexual or bisexual men, 86 drug-abusers and homosexual or bisexual men, 143 without risk behaviour. Only 120 patients had antibodies to human immunodeficiency virus type I. All were throughly examined for evidence of oral disorders. The major finding was that almost all with AIDS and AIDS-related complex had oral manifestations one AIDS-patient was affected with hairy leukoplakia.

AIDS-Related Complex↗
PubMedDate not supplied

[Oral pathology in 161 asymptomatic and symptomatic HIV-positive patients].

The aim of this study was to establish the prevalence of oral manifestations in HIV-infected patients and to correlate their frequency with the clinical stage. One hundred and sixty one HIV-positive individuals were examined, of whom 64 (40%) were in stages CDC-II and III and 97 (60%) in stage CDC-IV. The patients were examined at the AIDS out-patient clinic of the Instituto Nacional de la Nutrición Salvador Zubirán. The oral exams were performed by three examiners who were intra and inter calibrated, so that standard clinical criteria were followed. One hundred and twenty five patients (78%) showed one or more oral lesions. The proportion of patients with oral lesions increased significantly (p less than 0.05) according to the severity of the infection. Hairy leukoplakia (40%) and erythematous candidiasis (31%) were the most frequent lesions. When the prevalence of the different oral lesions was compared between the patients at early stages with the patients at the late stage no significant differences were found; only the pseudomembranous candidiasis and the exfoliative cheilitis were found with significantly higher values at stage CDC-IV than at earlier stages (p less than 0.001 and p less than 0.05 respectively). No association was found between oral candidiasis and tobacco use or xerostomia. Our study demonstrates that the prevalence and clinical features of the oral manifestations found showed similarities with those reported in other countries, but ulcero-necrotizing gingivitis was not found in our patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Oral changes associated with end-stage liver disease and liver transplantation: implications for dental management.

In children, chronic liver disease has a variety of causes; its effects include malnutrition, bleeding tendencies, osteopenia, and rachitic changes in the skeleton. Chronic liver disease in children may have many oral manifestations, such as green staining of the teeth and gingiva, as well as enamel hypoplasia. Dental management may be complicated by many factors, like bleeding tendencies and inability to metabolize routine anesthetics. Patients who undergo increasingly successful liver transplantation require life-long immunosuppressive therapy, which has side-effects. Results of this study of nine patients, seven females and two males, show that the effects of end-stage liver disease are permanently recorded on the teeth. Six were examined both before and after liver transplantation; the other three, only afterwards. This study confirms and extends the findings of three previous reports describing the oral manifestations of congenital biliary atresia in childhood.

Biliary Atresia↗
PubMed2004

Neoplasms associated with paraneoplastic pemphigus: a review with emphasis on non-hematologic malignancy and oral mucosal manifestations.

The review included 163 cases of paraneoplastic pemphigus (PNP) reported between 1990 and 2003, including a new unique case of PNP associated with occult breast cancer and an ovarian cyst of borderline malignancy. Hematologic-related neoplasms or disorders were associated with 84% of the cases, with non-Hodgkin lymphoma (38.6%) as the most frequent, followed by chronic lymphocytic leukemia (18.4%) and Castleman's disease (18.4%). The non-hematologic neoplasms comprised 16% of all cases: epithelial origin-carcinoma (8.6%), mesenchymal origin-sarcoma (6.2%), and malignant melanoma (0.6%). Carcinoma cases comprised 58% of the non-hematologic neoplasms. Carcinoma cases (n = 14) consisted of adenocarcinoma (n = 7), squamous cell carcinoma (n = 2), multiple skin tumors probably basal cell carcinoma (n = 1), and bronchogenic carcinoma (n = 1). Of the 10 (6.2%) sarcoma cases, there was one case each of leiomyosarcoma, liposarcoma, malignant nerve sheath tumor, poorly differentiated sarcoma, reticulum cell sarcoma, dendritic cell sarcoma and inflammatory myofibroblastic tumor. The oral mucosa was involved in all of cases. Isolated oral ulcerations were the first sign in 45% of the cases. Diffuse and persistent oral ulcerations with a progressive course could be a sign of malignancy, either recognized or occult. In the absence of a clear diagnosis, malignancy should be suspected and extensive work-up performed. The full spectrum of signs of PNP may not be present initially. Repeated biopsies, direct and indirect immunofluorescence as well as screening indirect immunofluorescence on murine bladder are required for diagnosis. Clinicians should be highly suspicious when signs and symptoms suggestive of PNP are present in cancer patients, of hematologic and non-hematologic origin.

Adenocarcinoma↗
PubMed2001

Dental hygienists and infection control: knowledge, attitudes and behaviour in Italy.

This study evaluated knowledge, attitudes and behaviour regarding infection control of dental hygienists in Italy. Among the 185 responders to the self-administered mailed questionnaire, 91.3% agreed with the correct responses to the three questions on knowledge about infection prevention and control procedures chosen as an indicator of 'good' knowledge. However, 21% were uncertain whether, or disagreed that, dental instruments should be rinsed in water after contact with glutaraldehyde and 17.5% agreed that, or were uncertain whether, 10 min contact with glutaraldehyde provided sterilization. Only 36.5% knew all the five oral manifestations of acquired immunodeficiency syndrome (AIDS) (acute periodontal problems, candidiasis, hairy leukoplakia, herpes simplex virus, Kaposi's sarcoma) and this knowledge was significantly higher in dental hygienists with a lower number of years of practice. More than two-thirds used a steam sterilizer or glutaraldehyde for appropriate times and temperatures for disinfection/sterilization of instruments and used appropriate surface disinfection procedures. The correct application of disinfection or sterilization methods for instruments was more likely in the older respondents and in those who attended continuing education courses on infection control. A positive attitude was reported by the majority of dental hygienists who agreed that guidelines should be maintained and applied and was significantly more likely in younger respondents. Only 57.9% routinely follow all recommendations for infection control practices and their use was significantly higher in the older respondents. Educational programmes are needed for improving knowledge about oral manifestations of AIDS in order to support dentists to provide early diagnosis and about the correct use of procedures and universal precautions for preventing infections.

Adult↗
PubMed1994

Paracoccidioidomycosis manifesting as oral lesions: clinical, cytological and serological investigation.

Paracoccidioidomycosis (South American blastomycosis) is a systemic mycosis which can be associated with oral lesions. This study on a group of 14 patients showed oral lesions mainly on the gingival or alveolar mucosa, with pulmonary involvement detectable on chest radiography in most. Microscopic detection of the fungus on a direct smear showed positive results in all 14 patients. Serological investigations including immunodiffusion, counterimmunoelectrophoresis and immunoblot were also positive in 100% of cases. The results suggest that direct smear together with serology may obviate the need for lesional biopsy for the diagnosis of oral paracoccidioidomycosis.

Adult↗